脑出血患者使用醒脑静注射液后血浆白介素-6和肿瘤坏死因子-α浓度的变化研究

The research of change of interleukin-6 and tumor necrosis factor-α in plasma after Xingnaojing Injection were used in patients with cerebral hemorrhage

目的观察脑出血患者使用醒脑静注射液后血浆白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)浓度的变化规律。方法回顾性分析我院2008年2月～2011年10月收治入院的使用醒脑静注射液治疗的脑出血患者60例临床资料,另选择我院同期健康体检者60例作为对照组,测定60例脑出血患者采用醒脑静注射液治疗后24 h内、72 h、10 d时血浆IL-6、TNF-α含量,并与60例健康对照者测定结果进行对比分析。结果①脑出血发生后24 h内、72 h、10 d等不同时期血浆IL-6、TNF-α含量均明显高于正常对照组(P<0.01),与治疗24 h内、72 h比较,醒脑静注射液治疗10 d患者的IL-6、TNF-α含量明显下降(P<0.05);②30 mL以上组较10 mL以上组显著升高(P<0.05),但低于50 mL以上组(P<0.05);10 mL以上组明显低于50 mL以上组(P<0.01);③IL-6、TNF-α含量越高NDS平均评分越高,提示脑出血患者IL-6、TNF-α含量越高,预后生活质量越下降。多因素logistic回归分析,NDS与TNF-α、IL-6呈正相关(β为1.247、1.180,均P<0.05)。结论脑出血患者早期血清中IL-6、TNF-α含量明显升高,出血量与其后的生活质量有关。早期应用醒脑静注射液可控制感染、减轻脑水肿,从而达到改善神经功能的目的。

Objective To observe change and its law of interleukin -6 and tumor necrosis factor-α in plasma after Xing- naojing Injection were used in patients with cerebral hemorrhage. Methods The clinical data of 60 patients with cerebral hemorrhage treated with Xingnaojing Injection who were collected in the hospital from February 2008 to October 2011 had been analyzed retrospectively. 60 cases were the healthy check-up as control group in the same period. The concentration of plasma interleukin-6 （IL-6） and tumor necrosis factor alpha （TNF-α） of patients with cerebral hemorrhage were deter- mined within 24 hours, 72 hours, 10 days, and it was analyzed and compared to the results of controls. Results ①The con- tent of IL-6, TNF-α were significantly higher than that in control group after cerebral hemorrhage happened within 24 hours, 72 hours, 10 days and so on （P 〈 0.01）. The content of plasma IL-6, TNF-α of patients being treated by Xingnao- jing Injection for 10 days decreased obviously compared with being treated for 24 hours and 72 hours （P 〈 0.05）. ②The content of IL-6, TNF-α of patients with bleeding more than 30 mL were higher than them with bleeding more than l0 mL （P 〈 0.05）, but it was less than patients with bleeding 50 mL above （P 〈 0.05）. The content of IL-6, TNF-α of patients with bleeding 10 mL below group were the lowest among all groups （P 〈 0.01）. ③The more of concentration of IL-6, TNF-α, the higher average score of NDS was. It was showed that concentration of IL-6, TNF-α were in inverse proportion to the quality of life, whereas they were in proportion to NDS scores （beta=l.247, 1.180, P 〈 0.05）. Conclusion The content of IL-6, TNF-α in serum of patients with cerebral hemorrhage increased significantly in the early days, the amount of bleed- ing had related to the life quality. It can control infection, reduce cerebral edema by early application of Xingnaojing Injec- tion, so as to achieve the purpose of improving neural function.